Response to Tucker & Vuchinich (2015): Behavioral economics in the broader context of addiction science.

Abstract

In their commentary on our recent study 1, Tucker & Vuchinich 2 argue that the core feature of behavioral economics (BE) is the analysis of temporally protracted molar patterns of choice behavior. We appreciate this view, and agree that BE has been highly effective in characterizing patterns of substance use behavior over time. However, we contend that BE is also well-suited for examining behavior at a finer level of resolution, investigating moment-to-moment influences that contribute to decisions regarding substance use and related behaviors. To use Tucker & Vuchinich's 2 example, John may not be drinking alcohol right now, but his decision to do so (or not) stems from a dynamic interplay between stable individual difference factors (e.g. personality traits, attitudes) and situation-specific, within-person influences (e.g. craving, negative affect) that serve as immediate precursors of behavior. These proximal influences are viewed increasingly as critical contributors to substance misuse 3, 4. In our view, the argument that momentary dynamic changes, whether in cognitive states or BE indices, can be ‘safely ignored’ 2 runs counter to current research in addiction science and psychological science more broadly 5. Ignoring such within-person variation closes the door on a potentially fruitful direction for BE 6, 7. Considerable evidence suggests that the BE indices of demand and delay discounting exhibit meaningful change in response to relevant manipulations. Delay discounting rates, for instance, change in response to drug deprivation, environmental cues and acute drug administration (for a review, see 7). The level of alcohol demand is enhanced dynamically by many of the same manipulations 8, 9. Furthermore, demand is also sensitive to pharmacological interventions 10 and contextual factors such as next-day responsibilities 11. Although this is still a nascent research area, these promising findings are consistent with an efficient cause interpretation. This may help to clarify situational factors that impact choice behavior in addiction and, in turn, provide a point of entry for in-the-moment interventions 12 and the development of personalized medicine applications 13. Tucker & Vuchinich 2 noted that only the molar approach to BE has proved useful in extensions to drinking in the natural environment. Whether this holds for laboratory manipulations of demand remains an empirical question. Recent research has laid the necessary groundwork for examining how changes in BE indices translate into drinking behavior, including linking changes in demand with actual consumption in the laboratory 14-16. Our study was designed to provide proof of concept for testing whether within-person changes in demand predict drinking in the laboratory and the natural environment, as has been demonstrated for within-person variation in craving 17, 18. We agree with Tucker & Vuchinich that both efficient and final cause interpretations of BE indices are legitimate 2, as they have also discussed elsewhere (e.g. 19). Ultimately, it is worth emphasizing that BE was developed from integrating methods across disciplines, and addiction science relies increasingly upon integration across multiple domains and levels of analyses. We would argue against an interpretation of BE that impedes its incorporation into a broader range of addiction research. None. Funding for this work was provided by National Institute on Alcohol Abuse and Alcoholism Grants R01 AA 019546 to D.M.McC. and T32 AA 013526 to K.J.S.